go back

Connecticut rates for HCPCS Q4197

PuraPly XT, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.52 / $73.52 / $115.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $71.40 / $77.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $70.70
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $70.70 / $144.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.17 / $70.70 / $76.43